This single-center prospective observational study investigates the effect of body mass index (BMI) on intraoperative vasopressor requirements and spinal block characteristics in adult patients undergoing urological surgery under spinal anesthesia. Participants are classified into two cohorts according to BMI (\<27.5 kg/m² and ≥27.5 kg/m²).Patient enrollment for this prospective observational study started before trial registration; therefore, this record represents a retrospective registration.
This is a single-center prospective observational study conducted at a tertiary care hospital between May 2022 and December 2025. The study aims to evaluate the relationship between body mass index (BMI) and intraoperative ephedrine requirements, sensory and motor block characteristics, and hemodynamic responses in adult patients undergoing elective urologic surgery in the lithotomy position under spinal anesthesia. All patients received a standardized intrathecal dose of 3 mL 0.5% hyperbaric bupivacaine, and intraoperative hypotension was treated with intravenous ephedrine according to a predefined protocol. Patient enrollment for this prospective observational study began before registration of the study; therefore, this record represents a retrospective registration. Ethics approval was obtained from the institutional ethics committee prior to patient recruitment, and written informed consent was obtained from all participants.
Study Type
OBSERVATIONAL
Enrollment
120
Adıyaman University Faculty of Medicine Anesthesiology and Reanimation
Merkez, Adıyaman Province, Turkey (Türkiye)
Intraoperative ephedrine consumption (mg)
Cumulative intravenous ephedrine dose administered to treat hypotension (systolic arterial pressure \<90 mmHg or \>30% decrease from baseline) from the time of spinal anesthesia induction until the end of the surgical procedure.
Time frame: From spinal anesthesia induction until completion of surgery.
Maximum sensory block level
Highest thoracic dermatome level reached after intrathecal injection of 3 mL 0.5% hyperbaric bupivacaine, assessed by pinprick testing every 2 minutes.
Time frame: During intraoperative monitoring
Time to reach maximum sensory block (minutes)
Time in minutes from the intrathecal injection of hyperbaric bupivacaine until the maximum sensory block level is achieved.
Time frame: From intrathecal injection to maximum sensory level
Time to two-segment regression of sensory block
Time in minutes from the maximum sensory block level until regression of sensory block by two thoracic dermatomes.
Time frame: From maximum sensory block to two-dermatome regression
Time to reach Bromage score 3
Time in minutes from the intrathecal injection until development of complete motor block in the lower extremities (Bromage score 3)
Time frame: From intrathecal injection to complete motor block
Motor block recovery time(minutes)
Time in minutes from the intrathecal injection until the earliest detectable return of motor function in the lower extremities.
Time frame: From intrathecal injection to earliest detectable return of motor activity
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Hemodynamic parameters
Noninvasive systolic and diastolic arterial pressure and heart rate measured at baseline (before spinal anesthesia) and then at 5-minute intervals throughout the surgical procedure.
Time frame: Baseline and every 5 minutes during surgery.,